Resources for finding additional information needed to support advocacy campaigns

1
Resources for finding additional information
needed to support advocacy campaigns

• Part B Module II

2
Good evidence makes good advocacy

• Minimum legal purchase age
• Government monopoly
• Restriction on hours or days of sale, outlet
  density
• Alcohol taxes
• Lower alcohol strength

• Random Breath Testing
• Lowered BAC limits
• Administrative license suspension
• Graduated licensing for novice drivers
• Brief interventions for hazardous drinkers
• Treatment and detox

3
Data on young people and alcohol

• Rates of harm
• Mortality rates associated with alcohol
• Accident and injury rates
• Rates of crime associated with alcohol
• Number of drink driving offences/ road traffic
  crashes related to alcohol
• Morbidity rates (e.g. liver disease, heart
  disease, cancer, FASD)
• Suicide rates
• Poor performance at school
• Sexual health problems and unwanted pregnancies

• Consumption levels and attitudes towards
  drinking
• Prevalence of drinking for different age groups
• Average age of onset of regular drinking
• Rates of heavy episodic or binge drinking
• Current regulations and alcohol controls e.g.
  age/licensing restrictions in individual
  countries.

4
Useful databases

• The World Health Organization Global School-based
  Student Health Survey (WHO GSHS)
• WHO Global Status Report on Alcohol Policy
• The European Schools Survey Project on Alcohol
  and Other Drugs report (ESPAD)
• The Health Behaviour in School Children study
  (HBSC)
• European Monitoring Centre for Drugs Addiction
  (EMCDDA)
• Youth Risk Behavioral Surveillance System (YRBSS)
• Behavioural Risk Factor Surveillance System
  (BRFSS)

5
Tips and Suggestions

• Use the most recent statistics available
• Report trends over periods of time to help put
  the data into perspective
• Relate to the geographical area most relevant to
  your target audience
• Remember, when referencing data,
• the source must always be credited.

6
Conducting surveys/opinion polls

• Available national and regional opinion polls
• Add questions to existing surveys
• Collect data from general public and key
  stakeholders
• Coordinate school surveys with advocacy campaigns
• Use online tools
• www.surveymonkey.com
• www.dotsurvey.com
• www.freeonlinesurveys.com

7
Designing survey questionnaires

• Begin with an explanation of whos leading the
  research, why the data is being collected, and
  what is going to happen to the data after it has
  been submitted
• Adhere to ethical principles
• Consult a survey expert
• Keep it as short as possible
• Use incentives
• Word questions carefully (short and direct)
• Use open-ended questions sparingly
• Pilot the survey

8
Needs Assessment Exercise Establishing the Need
for Alcohol Policy

• Consult local and national resources such as
  school surveys, morbidity and mortality
  statistics, drinking-driving arrest data,
  alcohol-related emergency department admissions,
  etc.
• Use the Global Burden of Disease data base as
  well as WHO national statistics
• Review current concerns, existing policies, and
  the extent to which policy is evidence-based.
• Conduct interviews and focus groups with
  policymakers
• Conduct attitude surveys of public support for
  alcohol policies.

9
Part C Dealing with Junk Science

• How to deal with the alcohol industrys research
  and prevention programs

10
Corporation-induced Diseases (Disorders,
Disability and Social Harm)

• A generic concept applied to diseases and other
  health conditions attributed to consumption of
  hazardous industrial products such as tobacco,
  alcohol, food, guns, and gambling machines
• Harm caused to consumers, workers, or community
  residents who have been exposed in the
  marketplace, work site or community, to disease
  agents that are part of the products of corporate
  activity
• Jahiel, R. (2008) Corporation-induced diseases,
  upstream epidemiologic surveillance, and urban
  health. Journal of Urban Health. 85, 4, 517-531.

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Case Study- Finland
12
Cumulative Growth in Alcohol IndustrySocial
Aspect/Public Relations Organizations
Sources Witheridge (2003), Anderson (2005), ICAP
(2006)
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Social Aspect OrganizationsOstensible Role

• Support youth prevention activities
• Support scientific research
• Promote road safety and crime reduction

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Actual Role of Social Aspect Organizations

• Public relations
• Lobbying for industry-favorable policies
• Neutralize opposing views and criticism
• Promote industry-favored scientists
• Oppose unpopular but effective policies
• Support ineffective but popular policies

15
Corporate Practices that Influence Alcohol and
Tobacco Use and Misuse

• Product design -- modifications of product
  increase sales, profits or market share
• Marketing -- advertising and product promotions
  increase sales and market share, attract new
  customers and retain customer loyalty
• Retail distribution -- activities such as
  convenience make alcohol and tobacco more
  accessible to consumers
• Pricing -- product costs increase sales, profits,
  and market share
• Political influence lobbying, political
  contributions, and public relations activities
  can affect the policy environment

16
Areas where industry interests interact with
addiction science

• industry sponsorship of research funding
  organizations
• direct financing of university-based scientists
  and centers
• research conducted through contract research
  organizations
• research conducted by trade organizations and
  SAPROs
• publication of scientific documents and support
  of scientific journals
• sponsorship of scientific conferences and
  presentations at scientific conferences
• efforts to influence public perceptions of
  research, research findings and alcohol/tobacco
  policies

17
Areas where industry interests interact with
practice and policy

• Industry sponsorship of prevention programs,
  especially alcohol and tobacco education
• Industry self-regulation of advertising
• Industry social responsibility advertising
  messages
• Industry positions on effective alcohol and
  tobacco policies
• Industry involvement in writing national alcohol
  policies

18
History of the tobacco industry in relation to
scientific research

• Misuse of science and scientific information to
  market their products to vulnerable populations
  and to make cigarettes more addictive
• Internal documents show that the tobacco industry
  has used university-based scientists to oppose
  health policies designed to prevent diseases
  caused by cigarette smoking

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Questions for Discussion

• What is the impact of corporate practices on
  population health?
• Is industry collaboration (partnerships) with
  the scientific community, public health advocates
  and prevention professionals mainly designed to
  achieve their business objectives?
• What should be done about corporate intrusions
  into science and practice?
• Is there an opportunity to channel corporate
  responsibility into needed funding for research,
  prevention and treatment?

20
ICAP Survey of Health Authorities

• An international survey of 114 national health
  authorities
• Solicited views about alcohol policies and
  partnerships with the alcohol industry
• 42 response rate
• Concluded that alcohol education was a priority
  areas for partnerships, especially in developing
  countries

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Efforts to influence public perceptions of
research

• California Wine Institute publications and its
  website 1) made exaggerated claims about the
  health benefits of alcohol and wine 2) regularly
  omitted the cautionary statements made by
  scientists whose studies it cited and 3) failed
  to mention the health risks of alcohol
  consumption (Steinhardt and Hacker, 1997).
• Representatives of Portman Group nominated to sit
  on governmental advisory counsels charged with
  research funding and policy (Alcohol Education
  and Research Council)
• Portman Group invited criticism of the book,
  Alcohol Policy and the Public Good (Edwards et
  al., 1994)
• Representatives of Portman Group contribute to
  drafting of "A Harm Reduction Strategy for
  England"
• Critique of Swiss tax study (Gmel, et al., 2005)
  by economist paid by Groupement Suise des
  Spirituex de Marque
• Distilled Spirits Council of United States
  supports letters to the editor questioning the
  methodology of an NIH study concluding that
  alcohol advertising is associated with increased
  alcohol use by youth

22
Does industry funding affect alcohol policy and
program effectiveness?

• One study reported that industry funding of
  programs to prevent underage drinking was
  associated with an abandonment of a less
  expensive compliance check program
• Alcohol industry opposition to advertising bans
  in favour of self-regulation exposes millions of
  youth to alcohol marketing
• Industry opposition to alcohol taxes and
  availability restrictions leads to the adoption
  of less effective or ineffective policies (e.g.,
  alcohol education campaigns, designated driver
  programs) in many countries.

23
Can industry funding bias research findings?

• In a comparison of the conclusions of 24
  published review papers, Jorgensen et al. (2008)
  found that industry supported reviews of drug
  medications had more favourable conclusions than
  corresponding Cochrane reviews of the same drugs,
  and were also rated as being of lower
  methodological quality.
• Studies of anti-hypertensive drugs funded by a
  single drug company have a 55 rate of favourable
  results, compared with 18 if they are not funded
  by an industry source (Yank et al. (2008).
• In a review of breast cancer clinical trials, it
  was found that pharmaceutical industry
  involvement may affect study design, focus and
  results (Peppercorn et al., 2007). Studies that
  reported drug company sponsorship were more
  likely to be positive than non-sponsored studies
  (Bekelman et al., 2003).

24
Can industry funding bias research findings?

• A growing number of studies have shown that
  conflicts of interests in health research are
  associated with biased research findings that
  favor commercial interests at the expense of
  patient health
• It is 3.5 times more likely a study will yield a
  positive result about a product if that study is
  funded by industry (DeAngelis, 2007)
• In several integrative reviews of the evidence it
  has been argued that not only does this
  compromise scientific integrity, it also
  decreases public trust in research. (FASED, 2007
  Brennen et al., 2007 Kassirer, 2005 Krimsky,
  2003).

25
What is the extent of industry involvement in
alcohol research and prevention?

• Despite claims that the industry devotes millions
  to health-related alcohol research and
  prevention, the evidence suggests a rather small
  direct contribution, one that is unlikely to
  contribute to alcohol science, lead to prevention
  breakthroughs, or reduce the burden of
  alcohol-related illness.

26
What is the proper role of scientists and
prevention professionals?

• Alcohol scientists should be very wary about
  accepting research funding directly from the
  industry, its trade associations or SAPROs.
• Consulting arrangements wherein scientists are
  paid to critique the work of other scientists
  constitute a serious financial conflict of
  interest
• Acceptance of fees for book chapters, background
  reports, attending conferences and prevention
  activities should be prefaced by the following
  questions 1) To what extent is the activity
  designed to promote the commercial interests of
  the alcohol or tobacco industries? 2) Will the
  funding source be acknowledged?
• Funding from independent organizations (e.g.,
  ABMRF and ERAB) may be consistent with scientific
  and public health aims if the grant review
  process is independent, transparent and peer
  reviewed. But scientists and prevention
  professionals need to be careful that their
  objectivity and independence are not compromised
  by fraternizing with industry executives, paid
  travel to meeting sites, and consulting fees.

27
What about industry-sponsored dialogues and
"partnerships" in relation to public health
issues?

• The hands-off position refuse to engage in
  communication or collaboration with industry
  representatives, based on the assumption that the
  industrys commercial interests are incompatible
  with the values and aims of public health and
  with scientific research.
• The hands-on approach engage in dialogue with
  industry representatives, accept industry
  funding, and participate as partners in
  industry-funded scientific activities as long as
  independent judgment is maintained

28
A third way Engage with the industry only when
it promotes the interests of science and public
health

• Insist on industry support for evidence-based
  policies, and cessation of anti-scientific
  lobbying activities, as a precondition for
  dialogue about partnerships with scientists and
  prevention professionals
• Encourage monitoring of industry activities using
  advanced social science methods
• Be attentive to organizational legitimacy issues
• Conduct ethical hazard inventories before
  engaging in any partnerships, prevention
  initiatives, or mutual scientific activities
• Engage professional scientific organizations and
  NGOs in a critical review of industry-science
  relationships
• Insist on rigorous adherence to Conflict of
  Interest principles

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Should the alcohol and tobacco industries pay for
the societal costs of research, prevention and
policy?

• The attributable burden can be estimated
• The costs can be estimated
• It is agreed that alcohol and tobacco are no
  ordinary commodities
• General and dedicated taxation are accepted by
  governments and industry